Laparoscopic cholangiography: a new method and device

Laparoscopic cholangiography is invaluable in the detection of bile duct stones, visualization of ductal anomalies and discovery and prevention of iatrogenic injuries to the bile ducts. The use of this procedure is, however, limited by the technical difficulties of cystic duct cannulation. A method of laparoscopic cholangiography that avoids cystic duct cannulation is described. It consists of a Kumar I Cholangiography Clamp that is applied across the gallbladder just above the Hartmann's pouch and divides the gallbladder into a medial and lateral compartment. A Kumar Cholangio Catheter is then introduced through the side-channel of the clamp, puncturing the medial compartment (i.e. the Hartmann's pouch) with a short #22 gauge needle for aspiration, followed by dye injection. Cholangiography was obtained with remarkable ease in 49 of the first 50 cases (98%) without complication.